Minimally invasive medical apparatus for dispensing a biologically active compound and an associated medical procedure for dispensing a biologically active compound

ABSTRACT

A medical apparatus for dispensing a biologically active compound. The medical apparatus includes a sleeve, wherein (1) the sleeve has a working channel defined therein through which medical instruments may be advanced, (2) the sleeve includes a fluid delivery channel which is distinct from the working channel, (3) the fluid delivery channel has an exit, and (4) the sleeve includes a housing having an interior cavity defined therein. The medical apparatus also includes an insufflation valve in fluid communication with the working channel. The insufflation valve is positionable between an open position and a closed position such that (i) when the insufflation valve is located in the open position an insufflation gas can be advanced into the working channel and (ii) when the insufflation valve is located in the closed position the insufflation gas is prevented from being advanced into the working channel. The medical apparatus further includes a chemical container having an interior void defined therein for receiving the biologically active compound, wherein the interior void is in fluid communication with the exit through the fluid delivery channel when the chemical container is positioned within the interior cavity of the housing such that the biologically active compound may be delivered through the fluid delivery channel to an outer surface of the sleeve.

BACKGROUND OF THE INVENTION

The present invention generally relates to a medical apparatus andprocedure for dispensing a biologically active compound. The presentinvention particularly relates to a medical apparatus and procedure fordispensing a biologically active compound during a minimally invasivesurgical technique, such as laparoscopic surgery.

Minimally invasive surgical techniques, such as laparoscopic surgery,typically include the use of a trocar assembly. A trocar assemblyincludes a trocar (sometimes referred to as an “obturator”) positionedwithin the lumen of a cannula. The trocar and cannula are advancedthrough a body cavity wall so as to create a small opening or a portsite wound therein. The trocar is then completely removed from the lumenof the cannula such that the cannula's lumen provides an entrance forlaparoscopic instruments into the interior of the body cavity. The bodycavity is then insufflated with an inert gas, such as CO₂, to provideeasier access to the organs contained therein. An alternative toinsufflation, which also aids in intra-abdominal visualization andprovides access to the organs, is a mechanical lifting device. Once thesurgery is complete the cannula is completely removed from the port sitewound to rapidly desufflate the body cavity.

Surgery performed by using minimally invasive techniques is generallyassociated with lower postoperative morbidity, slower tumor growth,shorter postoperative stay, less postoperative pain, decreased cost, andquicker recovery as compared to “open” or conventional surgicaltechniques^((1, 2, 3, 4, 5, 6)). Because of the aforementionedadvantages, these minimally invasive techniques are being applied to anincreasing variety of all surgical procedures. For example, laparoscopicprocedures for the resection of malignancies have emerged. Inparticular, laparoscopic colectomy for carcinoma of the colon has beendeveloped, and it has been reported that the initial results of theseprocedures have advantages over operations performed in the traditionalopen manner^((5, 6, 14)). Moreover, it is hoped that the long termresults of these procedures will be comparable, or better than, thoseperformed in the traditional open manner.

However, the development of laparoscopic surgery for cancer has beenhindered because of the major concern regarding the implantation oftumor cells in the port site wound^((2, 3, 6, 7)). In fact, numerousport site recurrences have been documented in the medical literatureheretofore, and these recurrences are associated with a decreasedsurvival rate for patients who may have had a curativecancer^((2, 3, 6,)). Specifically, the medical literature reports thatthe incidence of tumor cell implantation ranges from as high as 20% toas low as 0%⁽⁸⁾. The studies generating the aforementioned data utilizedhighly skilled and experienced laparoscopic surgeons practicing at majoruniversity programs. However, in spite of utilizing highly skilled andexperienced laparoscopic surgeons, the data indicates that the incidenceof tumor cell implantation in the surgical wound is greater whenemploying laparoscopic techniques as compared to when conventionalsurgical techniques are used (i.e. 0.6% implantation incidence forconventional techniques⁽⁹⁾ compared to 1% incidence for laparoscopictechniques⁽¹⁰⁾.

Several mechanisms may be responsible for the above discussedimplantation of tumor cells in the port site wound. For example,minimally invasive surgical techniques for treating cancer require theinsertion and removal of laparoscopic instruments or cameras through thelumen of the cannula. In addition, these surgical techniques requirethat the cannula itself be moved relative to the port site wound suchthat the cannula is advanced further into, or withdrawn from, the bodycavity⁽¹¹⁾. Moving the cannula in the above described manner facilitatesa surgeon's ability to optimally locate instruments within the bodycavity thereby helping to ensure the successful completion of themedical procedure. However, the aforementioned manipulations of thelaparoscopic instruments and cannula may result in the exposure of theport site wound to exfoliated cancer cells which creates a risk ofimplanting tumor cells in the walls of the port site wound^((11, 12)).In particular, exfoliated cancer cells may adhere to and thuscontaminate a portion of the exterior surface of the cannula^((11, 12)).The contaminated portion of the exterior surface of the cannula may thenbe advanced into contact with the port site wound during insertion andremoval from the port site wound^((11, 12)). This contact may dislodgethe exfoliated cancer cells from the exterior surface of the cannula andthus cause the exfoliated cancer cells to be implanted in the port sitewound^((11, 12)).

Furthermore, studies have shown that a physician may undergo asignificant learning curve before becoming proficient in the performanceof advanced laparoscopic surgery, such as cancer surgery^((3, 13, 16)).As a result, a relatively inexperienced surgeon may have a tendency tomanipulate or handle a tumor to a greater degree during a surgicalprocedure than an experienced surgeon. Studies have shown a 14.6%incidence of viable tumor cells in proximity of the specimen where thesurgeon is working with his or her instruments⁽¹⁵⁾. In addition, aninexperienced surgeon may have a tendency to insert and withdraw aninstrument through the lumen of the cannula a greater number of timesthan an experienced surgeon. The above described increased manipulationof the instrument or the tumor can result in a greater incidence oftumor cell implantation in the port site wound^((11, 12)).

Regardless of how these cells contaminate the wound, once implantedtherein, viable tumor cells can cause a subcutaneous metastases or “portsite recurrence” after the resection of malignant tissue. These “portsite recurrences” have delayed the advancement of laparoscopic cancersurgery^((2, 6, 7, 8, 9, 10, 11, 12)) into all fields of cancer surgery,and is one reason why the benefits of laparoscopic surgery have not beenavailable to cancer patients.

Furthermore, laparoscopic surgery performed for general surgery,gynecological surgery, urological surgery, or any other intra-abdominalinfection is associated with a small but real incidence of port sitewound infection⁽¹⁾. The infecting bacteria causing these illnesses cancontaminate the port site wound in the same manner as discussed abovewith regard to tumor cell contamination, and these infections canincrease a patient's morbidity and consequently the length of apatient's hospital stay, thereby considerably increasing their hospitalbill.

One way of addressing the problem of potential tumor or infectious cellimplantation in the port site wound is to apply a biologically activecompound, such as a cytotoxic agent which kills tumor or infectiouscells, on a medical apparatus (e.g. a trocar assembly) utilized in thelaparoscopic procedure. By placing such a compound on the medicalapparatus the biologically active compound becomes disposed on theinterior surface of the body cavity and on the surface of the port sitewound. Having the biologically active compound disposed on the medicalapparatus, the interior surface of the body cavity, and the surface ofthe port site wound establishes a “pharmacological barrier” whichprevents any viable tumor or infectious cells from becoming implanted inthe port site wound.

Heretofore, biologically active compounds were disposed on the medicalapparatus by various methods. For example, dipping the medical apparatusin a solution or suspension of the biologically active compound,applying the biologically active compound to the medical apparatus withan applicator such as a cotton swab, or injecting the intraperitonealsurface with the biologically active compound^((16, 17)). However, theaforementioned methods of administering the biologically active compoundsuffer from several drawbacks. For example, these methods areinconvenient, messy, inexact, or highly variable. In addition, thesemethods do not allow the amount of the biologically active compoundadministered to the patient via the medical apparatus to beappropriately controlled. Controlling the amount administered to apatient is important since it allows the physician to carefully adjustthe dose of the biologically active compound and thus avoid anyundesirable side effects while maximizing the delivery of thebiologically active compound. In addition, controlling the dose allowsthe physician to collect dose response data, and thus measure theeffectiveness of various pharmacological regimens. With the recentadvances in the fields of biotechnology, genetic engineering, andpharmacology, there is a need to accurately, efficiently, andreproducibly deliver current and future biologically active agentsduring the performance of a minimally invasive surgical technique.

What is needed therefore is a medical apparatus and procedure fordisposing a biologically active compound which addresses the abovedescribed drawbacks.

TABLE OF REFERENCES CITED IN THE BACKGROUND

1. Lord et al., Dis. Col. Rect. 39(2):148 (1996)

2. Berman, Important Advances in Oncology 1996, Laparoscopic Resectionfor Colon Cancer: Cause for Pause, Vincent DeVita Ed., p.231

3. Falk et al., Dis. Col. Rect. 36:28 (1993)

4. Liberman et al., Surg. Endo. 10:15 (1996)

5. Whelan et al., Dis. Col. Rect. 41(5):564 (1998)

6. Wexner et al., Am. Surg. 64(1):12-18 (1998)

7. Greene, Semin. Lap. Surg. 2(3):153 (1995)

8. Kazemier, Surg. Endo. 9:216 (1995)

9. Reilly et al., Dis. Col. Rect. 39(2):200 (1996)

10. Jacquet et al., Dis. Col. Rect. 38(10):140 (1995)

11. Reymond et al., Surg. Endo. 11:902 (1997)

12. Allardyce et al, Dis. Col. Rect. 40(8):939 (1997)

13. Caushaj et al., Dis. Col. Rect. 37(4):21 (Podium Abstract 1994)

14. Lee et at, (oral presentation, 6^(th) World Congress of EndoscopicSurgery, June 1998) Surgical Endoscopy 12 (5):14 (1998)

15. Russell et al., Dis. Col. Rect. 40 (11):1294 (1997)

16. Neuhaus SJ, (oral presentation, 6 ^(th) World Congress of EndoscopicSurgery, June 1998) Surgical Endoscopy 12 (5): 515 (1998)

17. Schneider C, (oral presentation, 6 ^(th) World Congress ofEndoscopic Surgery, June 1998) Surgical Endoscopy 12 (5): 517 (1998)

SUMMARY OF THE INVENTION

In accordance with one embodiment of the present invention, there isprovided a medical apparatus for dispensing a biologically activecompound. The medical apparatus includes a trocar assembly including acannula and a trocar, wherein (1) the cannula has a working channeldefined therein through which medical instruments may be advanced, (2)the cannula includes a fluid delivery channel which is distinct from theworking channel, and (3) the fluid delivery channel has an exit. Themedical apparatus also includes a valve in fluid communication with theworking channel. The valve is positionable between an open position anda closed position such that (i) when the valve is located in the openposition a gas can be advanced into the working channel and (ii) whenthe valve is located in the closed position the gas is prevented frombeing advanced into the working channel. The medical apparatus furtherincludes a chemical container having an interior void defined thereinfor receiving the biologically active compound. The interior void is influid communication with the exit through the fluid delivery channel,whereby the biologically active compound may be delivered through thefluid delivery channel to an outer surface of the cannula.

Pursuant to another embodiment of the present invention, there isprovided a medical procedure for dispensing a biologically activecompound. The medical procedure includes the steps of (a) creating anopening in a wall of a non-vascular body cavity, (b) advancing a medicalapparatus through the opening and into the non-vascular body cavity, themedical apparatus including a trocar assembly having (1) a cannula and atrocar, wherein (A) the cannula has a working channel defined thereinthrough which medical instruments may be advanced, (B) the cannulaincludes a fluid delivery channel which is distinct from the workingchannel, and (C) the fluid delivery channel has an exit, and (2) achemical container having an interior void defined therein for receivingthe biologically active compound, the interior void being in fluidcommunication with the exit through the fluid delivery channel, and (c)advancing the biologically active compound from the interior void of thechemical container onto an exterior surface of the cannula through afluid path defined by the fluid delivery channel.

According to yet another embodiment of the present invention, there isprovided a medical apparatus for dispensing a biologically activecompound. The medical apparatus includes a sleeve, wherein (1) thesleeve has a working channel defined therein through which medicalinstruments may be advanced, (2) the sleeve includes a fluid deliverychannel which is distinct from the working channel, and (3) the fluiddelivery channel has an exit. The medical apparatus also includes ahousing secured to the sleeve. The housing has an interior void definedtherein for receiving the biologically active compound, wherein theinterior void is in fluid communication with the exit through the fluiddelivery channel such that the biologically active compound may bedelivered through the fluid delivery channel to an outer surface of thesleeve. The medical apparatus further includes an insufflation valve influid communication with the working channel. The insufflation valve ispositionable between an open position and a closed position such that(i) when the insufflation valve is located in the open position aninsufflation gas can be advanced into the working channel and (ii) whenthe insufflation valve is located in the closed position theinsufflation gas is prevented from being advanced into the workingchannel.

According to yet another embodiment of the present invention, there isprovided a medical apparatus for dispensing a biologically activecompound. The medical apparatus includes a trocar assembly including acannula and a trocar. The cannula has a working channel defined therein,and the working channel has a cross-sectional area sized for passage ofa laparoscope therethrough. The cannula includes a fluid deliverychannel which is distinct from the working channel. The fluid deliverychannel has an exit. The medical apparatus also includes a chemicalcontainer having an interior void defined therein for receiving thebiologically active compound. The interior void is in fluidcommunication with the exit through the fluid delivery channel, wherebythe biologically active compound may be delivered through the fluiddelivery channel to an outer surface of the cannula.

According to still another embodiment of the present invention, there isprovided a medical procedure for dispensing a biologically activecompound. The medical procedure includes the steps of (i) creating anopening in a wall of a body cavity, (ii) advancing a medical apparatusthrough the opening and into the body cavity, the medical apparatusincluding a trocar assembly having (1) a cannula and a trocar, wherein(A) the cannula has a working channel defined therein through whichmedical instruments may be advanced, (B) the cannula includes a fluiddelivery channel which is distinct from the working channel, and (C) thefluid delivery channel has an exit port, and (2) a chemical containerhaving an interior void defined therein for receiving the biologicallyactive compound, the interior void being in fluid communication with theexit port through the fluid delivery channel, (iii) advancing a gas intothe body cavity, and (iv) advancing the biologically active compoundfrom the interior void of the chemical container onto an exteriorsurface of the cannula through a fluid path defined by the fluiddelivery channel.

According to yet another embodiment of the present invention, there isprovided an arrangement for delivering a biologically active compound.The arrangement includes a chemical container configured to be removablydisposed in a void of a housing of a trocar assembly.

It is therefore an object of the present invention to provide a new anduseful medical apparatus for protecting a port site wound.

It is another object of the present invention to provide an improvedmedical apparatus for protecting a port site wound.

It is still another object of the present invention to provide a new anduseful medical apparatus for dispensing a biologically active compound.

It is another object of the present invention to provide an improvedmedical apparatus for dispensing a biologically active compound.

It is moreover an object of the present invention to provide a new anduseful medical procedure for protecting a port site wound.

It is still another object of the present invention to provide animproved medical procedure for protecting a port site wound.

It is moreover an object of the present invention to provide a new anduseful medical procedure for dispensing a biologically active compound.

It is still another object of the present invention to provide animproved medical procedure for dispensing a biologically activecompound.

The above and other objects, features, and advantages of the presentinvention will become apparent from the following description andattached drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an exploded perspective view of a medical apparatus insertedthrough a body cavity wall which incorporates the features of thepresent invention therein, with the body cavity wall shown incross-section for clarity of description;

FIG. 2 is an enlarged fragmentary cross sectional view of the medicalapparatus of FIG. 1, showing the chemical containers inserted into thehousing;

FIG. 3 is an enlarged fragmentary perspective view of the medicalapparatus of FIG. 1, showing the interior cavity of the housing;

FIG. 4 is an enlarged perspective view of one of the chemical containersshown in FIG. 1;

FIG. 5 is a view similar to FIG. 4, but showing an under portion of thechemical container,

FIG. 6 is a fragmentary perspective view of the medical apparatus ofFIG. 1, but with a pressure source schematically shown coupled thereto;

FIG. 7 is a cross sectional view of a second embodiment of the medicalapparatus of the present invention; and

FIG. 8 is an enlarged view of a portion of FIG. 3 which is encircled andindicated as FIG. 8;

FIG. 9 is an exploded perspective view of another medical apparatusinserted through a body cavity wall which incorporates the features ofthe present invention therein;

FIG. 10 is an enlarged fragmentary cross sectional view of the medicalapparatus of FIG. 9, showing the chemical containers inserted into thehousing;

FIG. 11 is a view similar to the one shown in FIG. 9, but having thegrooves of the medical device defined on an interior surface of themedical apparatus; and

FIG. 12 is a view similar to the one shown in FIG. 10, but having thegrooves of the medical device defined on an interior surface of themedical apparatus.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

While the invention is susceptible to various modifications andalternative forms, a specific embodiment thereof has been shown by wayof example in the drawings and will herein be described in detail. Itshould be understood, however, that there is no intent to limit theinvention to the particular form disclosed, but on the contrary, theintention is to cover all modifications, equivalents, and alternativesfalling within the spirit and scope of the invention as defined by theappended claims.

First Embodiment of the Invention

Referring to FIGS. 1, 2, and 3, there is shown a medical apparatus 10 ofthe present invention advanced through an opening 52 (i.e. the port sitewound) in a wall 54 of a body cavity 56. The medical apparatus 10includes a trocar assembly 14 and a pair of chemical containers 26.Trocar assembly 14 includes a cannula 16 and a trocar 18. Cannula 16includes (1) a wall having an outer surface 30, (2) a working channel 20defined by wall 32, (3) a housing 34, and (4) a pair of fluid deliverychannels 22 which are distinct from working channel 20.

Housing 34 includes an exterior wall segment 110 and an interior wallsegment 112 (see FIGS. 2 and 3). Housing 34 also includes an annularshaped interior cavity 36 defined between exterior wall segment 110 andan interior wall segment 112. As shown more clearly in FIG. 1, exteriorwall segment 110 has a pair of passageways 88 defined therein which leadto interior cavity 36. As shown in FIG. 3, exterior wall segment 110also has a track 90 defined therein such that one track 90 is positionedwithin each passageway 88. In addition, each passageway has a door 94positioned therein such that door 94 is located within track 90. Havingthe above described arrangement allows each door 94 to slide withintrack 90 relative to exterior wall segment 110 in the directionsindicated by arrow 96. Sliding doors 94 in the aforementioned mannerallows each door 94 to be located in an open or a closed position. Forexample, FIG. 3 shows door 94 in an open position so as to provideaccess to interior cavity 36 of housing 34.

Referring now to FIGS. 2 and 6, housing 34 also has an insufflationvalve 108 and a pressure control valve 50 attached thereto. Insufflationvalve 108 and pressure control valve 50 extend through exterior wallsegment 110 and are attached to interior wall segment 112. Insufflationvalve 108 is in fluid communication with working channel 20. As shown inFIG. 2, insufflation valve 108 is also in fluid communication withpressure control valve 50 via a bleed line 106 defined in interior wallsegment 112. Pressure control valve 50 is positioned within a pressureline 46 defined in interior wall segment 112. Pressure line 46 has apair of entrance ports 114 (also see FIGS. 3 and 8) which lead tointerior cavity 36 of housing 34. Each entrance port 114 defines anentrance port end wall 40 (also see FIG. 3 and 8).

As shown in FIG. 8, housing 34 includes a fluid delivery needle 38having a base 100 attached thereto which is positioned in contact witheach entrance port end wall 40 of pressure line 46 such that each fluiddelivery needle 38 extends into interior cavity 36 of housing 34 (seeFIG. 3). Base 100 is secured to each entrance port end wall 40 with anappropriate adhesive (not shown). Each fluid delivery needle 38 has aneedle aperture 102 defined therein. Needle aperture 102 leads to alumen 104 which in turn leads to pressure line 46 in fluid communicationwith interior cavity 36 through fluid delivery needle 38.

Referring back to FIGS. 1-3, it should be understood that each fluiddelivery channel 22 is preferably defined in wall 32 of cannula 16. Eachfluid delivery channel 22 extends substantially along the entire lengthof cannula 16. In addition, each fluid delivery channel 22 has a numberof exit ports 24 in fluid communication therewith which lead to outersurface 30 of cannula 16. As shown in FIG. 3, each fluid deliverychannel 22 has a branched end 98 which extends into housing 34. Branchedend 98 of each fluid delivery channel 22 defines three additionalentrance ports 114 in interior wall segment 112 which lead to interiorcavity 36 of housing 34 (i.e. there are a total of six entrance ports114 defined by the pair of fluid delivery channels 22 and two entranceports defined by pressure line 46). Each entrance port 114 defines anentrance port end wall 40. It should be understood that having entranceports 114 positioned in the above described manner places fluid deliverychannels 22 in fluid communication with interior cavity 36 of housing34. In a manner substantially identical as that described above inreference to FIG. 8, a fluid delivery needle 38 is attached to eachentrance port end wall 40 via a base 100 so as to place each fluiddelivery channel 22 in fluid communication with interior cavity 36through fluid delivery needle 38 (see FIG. 3).

As shown in FIG. 6, a pressure source 48 is connected to insufflationvalve 108 via hose 116. It should be understood that when insufflationvalve 108 is located in an open position (see FIG. 6), a pressurizedfluid such as CO₂ can be advanced from pressure source 48 through hose116 and insufflation valve 108, and into working channel 20 of cannula16. Once in working channel 20, the fluid is advanced into body cavity56 to cause insufflation thereof. It should be understood thatinsufflation valve 108 can also be located in a closed position (notshown) so as to prevent fluid from being advanced from pressure source48 to body cavity 56. In addition, it should be appreciated thatinsufflation valve 108 can be located in a desufflate position (notshown) so as to allow pressurized fluid contained within an insufflatedbody cavity 56 to escape. Specifically, placing insufflation valve 108in the desufflate position allows the pressurized fluid contained withinan insufflated body cavity 56 to be advanced from body cavity 56 to thesurrounding environment through working channel 20, insufflation valve108, and an escape port 118 attached to insufflation valve 108.

It should also be understood that insufflation valve 108 and pressurecontrol valve 50 can be positioned such that pressure line 46 (see FIG.2) is in fluid communication with pressure source 48 via a fluid pathdefined by hose 116, insufflation valve 108, bleed line 106 (see FIG.2), and pressure control valve 50. Therefore, it should be appreciatedthat pressurized fluid can be advanced from pressure source 48 to thepair of fluid delivery needles 38 in fluid communication with pressureline 46 (see FIG. 2).

Referring now to FIGS. 1, 2, 4, and 5, each chemical container 26 has aninterior void 28 defined therein (see FIGS. 2 and 4) for receiving abiologically active compound 12. Each chemical container 26 alsoincludes three exit apertures 42 defined therein (see FIG. 4) which arein fluid communication with interior void 28. Each exit aperture 42 hasa diaphragm 44 positioned therein so as to prevent biologically activecompound 12 from leaking out of interior void 28. Each diaphragm 44 canbe made of, for example, silicone rubber. Each chemical container 26also includes a pressure aperture 120 (see FIG. 4) in fluidcommunication with interior void 28. Each pressure aperture 120 has adiaphragm 44 positioned therein so as to form a fluid tight seal betweeninterior void 28 and the exterior of chemical container 26. As shown inFIG. 5, each chemical container 26 further includes a loading aperture122 with a diaphragm 44 positioned therein so as to prevent biologicallyactive compound 12 from leaking out of interior void 28. Chemicalcontainers 26 also include (1) a pressure relief valve 124 in fluidcommunication with interior void 28 and (2) three ribs 126 definedthereon.

Biologically active compound 12 includes chemical substances such asantibiotics, cytotoxic agents or compounds which effectively inhibittumor cell adherence to a membrane. A large number of antimicrobialagents (i.e. antibiotics) or antiseptics are contemplated for use asbiologically active compound 12 in the present invention. Preferably,where possible, the antibiotic should be active against bothGram-positive and Gram negative pathogens. The following areillustrative of the antibiotics and/or antiseptics which can be disposedin interior void 28 to aid in the control, inhibition, or prevention ofinfections of opening 52: (i) metal salts, or like compounds withantibacterial metal ions, e.g. copper or silver, and optionally withadditional nonmetallic ions of antibacterial properties; (ii) topicalantibiotics, e.g. neomycin, soframycin, bacitracin, polymcin; (iii)antibacterials such as chlorhexidine and its salts; (iv) quaternaryammonium compounds, e.g. centrimide, domiphen bromide, and polymericquaternaries; (v) iodophors such as povidone iodine, andpolyvinylpyrrolidone-iodine (PVP-I); (vi) acridine compounds such as9-aminoacridine, 3,6-diaminoacridine and 6,9-diamino-2-ethoxyacridine;and (vii) biguanidine compounds such as1,6-di(4-chlorophenylbiguanido)hexane, diaminohexylbiguanide,1,6-di(aminohexylbiguanido)hexane, and polyhexamethylenebiguanide.Additional suitable antibiotics include aminoglycoside antibiotics suchas amikacin, butirosin, dideoxykanamycin B (DKP), fortimycin,gentamycin, kanamycin, lividomycin, neomycin, netilmicin, ribostamycin,sagamycins, seldomycins and their epimers, sisomicin, sorbistin,tobramycin, streptomycins, linkomycins such as clindamycin, lincomycinand rifamycins such as rifampicin and rifamycin. Antibiotics such aspolymyxin B sulfate-neomycin sulfate, cleocin phosphate (available fromthe Upjohn Company, Kalamazoo, Mich.) and erythromycin ethylsuccinateare also contemplated.

Examples of suitable antiseptics include bromchlorophen, hexetidine,buclosamide, salicylic acid, cerium nitrate, chlorhexidine,5-chloro-8-hydroxyquinoline, copper 8-hydroxyquinolate, acridine orange,undecenoic acid, undecoylium chloride and silver salts such as silversulfadiazine, mafenide, nitrofurazole, cloflucarban, tribromasalan,taurolin and noxythiolin.

With respect to aiding in the control, inhibition or prevention of tumorcell adhesion and implantation and the subsequent metastasis via opening52, compounds which effectively block or inhibit tumor cell adhesion(please note that tumor cell adhesion is a step in the metastasiscascade), or destroy tumor cells before adhering to a side wall 58 ofopening 52, or other sites, can be disposed in interior void 28. Typesof compounds which effectively block or inhibit tumor cell adherenceinclude anticoagulants, fibrinolytic agents and compounds which alterthe electrical charge of a membrane surface. For example, the surfacecharge altering and anticoagulant heparin can be disposed in interiorvoid 28. Additionally, any of several water-soluble high molecularweight glucose polymers (average molecular weight (MW) 75 kdal)otherwise known as dextrans, can also be disposed in interior void 28 toalter the surface electrical charge of any contacted membranes therebyblocking tumor cell adhesion. Preferably a dextran having an average MWof about 40 kdal is used to coat outer surface 30.

As stated above, tumor cell destroying compounds, hereinafter referredto as cytotoxic compounds, can also be disposed in interior void 28.These compounds include cisplatin, carboplatin, 5-fluorouracil,providoneiodine, tumor necrosis factor (TNF)-α, tauromustine, mitomycinC, camptothecin, bleomycin, indomethacin, N-methyl formamide, tamoxifen,sodiumhypochlorite, chlorhexidinecetrimide, adriamycin, methotrexate.Tumor cell destroying compounds also include antimetabolites such ascytarabine, azaribine, mercaptopurine, thioguanine; natural productssuch as vinblastine, vincristine, dactinomycin, daunorubicin,doxorubicin, bleomycin, mithramycin, mitomycin; and other miscellaneousagents such as cisplatin, hydroxyurea, procarbazine and mitotane,Alkylating agents such as mechlorethamine, nitrogen mustards,ethlenimine derivatives, alkyl sulfonates, nitrosoureas, and triazenesare also contemplated. Moreover, the compounds disclosed by Krakoff,Irwin H. in Systemic Treatment of Cancer, CA Cancer J. Clin., vol. 46,No. 3, pages 134-141 (May/June 1996), which is incorporated herein byreference, are contemplated for being disposed in interior void 28.

In addition antiangiogenesis agents such as angiostatin and endostatinare included in the group of cytotoxic compounds to be disposed ininterior void 28. Moreover, antibodies, including human monoclonalantibodies are included as cytotoxic compounds. Preferably, the humanmonoclonal antibody HuMab SK1 as described by Chang, Helena R. et al. inHuman Monoclonal Antibody SK1-Mediated Cytotoxicity Against Colon CancerCells, Dis. Colon Rectum, vol. 36, No. 12, pages 1152-1157 (December1993) which is incorporated herein by reference, is disposed in interiorvoid 28. Other monoclonal antibodies can also be disposed in interiorvoid 28, for example those produced from hybridomas having the accessionnumbers HB8573, HB8232 and HB8250 available from the American TypeCulture Collection, located at 12301 Parklawn Drive, Rockville Md.,20852. Furthermore, interleukin 2 (IL-2), cytokines or lymphokines arealso included in the group of cytotoxic compounds of the presentinvention. Also contemplated are hyaluronate coating solutions. Inaddition, gene based cancer drugs are contemplated. Examples of suchinclude gene based cancer drugs directed toward the RAS gene. Anotherexample of a gene based cancer drug is a drug directed toward the EGFreceptor (i.e. EGFR). It should also be, understood that a combinationof any of the above compounds can be disposed in interior void 28.

During use of medical apparatus 10, trocar 18 is initially located in afirst trocar position as shown in phantom in FIG. 1 (i.e. trocar 18 ispositioned within working channel 20 of cannula 16). In addition,chemical containers 26 are located outside of interior cavity 36 ofhousing 34 and doors 94 (see FIG. 3) are located in the closed position(not shown). Trocar 18 of medical apparatus 10 is then placed in contactwith, and advanced through, wall 54 of body cavity 56 to create opening52 as shown in FIG. 1. Preferably, medical apparatus 10 is advancedthrough a wall 54 of a non-vascular body cavity 56. What is meant hereinby non-vascular body cavity 56 is a body cavity which is not defined byone or more blood vessels. Examples of non-vascular body cavities 56 inwhich medical apparatus 10 is preferably used include the peritonealcavity and the thoracic cavity. Once medical apparatus 10 is positionedas described above, trocar 18 is moved to a second trocar position (i.e.trocar 18 is completely removed from working channel 20 of cannula 16).Insufflation valve 108 is then located in the open position (see FIG. 6)so that pressurized CO₂ is advanced from pressure source 48 through hose116 and insufflation valve 108, and into working channel 20 of cannula16. Once in working channel 20, the pressurized CO₂ is advanced intobody cavity 56 to cause insufflation thereof. Once body cavity 56 isinsufflated a medical instrument, such as a laparoscope (not shown), isinserted down through working channel 20 and into body cavity 56 suchthat a surgeon can visually inspect the interior of body cavity 56 forpossible signs of cancer (e.g. the presence of a tumor in body cavity56) or an infection. Therefore, it should be appreciated that thecross-sectional area of working channel 20 should be sized for thepassage of a laparoscope therethrough. For example, typical laparoscopeshave diameters of about 5 mm to about 10 mm. Thus, working channel 20should have a diameter or cross-sectional area sized to accommodate theinsertion of a laparoscope therethrough. After inspecting the interiorof body cavity 56 with a laparoscope and no signs of cancer or infectionare detected, and the surgeon is satisfied that no cancer or infectionis present within body cavity 56, the surgical procedure can proceed ina manner that is well known in the art.

However, if cancer or infection is detected within body cavity 56, or ifthe surgeon suspects cancer or an infection is present, each chemicalcontainer 26 is loaded, under the surgeon's direction, with apredetermined amount of an appropriate biologically active compound 12.Specifically, a syringe (not shown) is filled with a predeterminedamount of the appropriate biologically active compound 12 and thehypodermic needle of the syringe is inserted through diaphragm 44 ofloading aperture 122 (see FIG. 5). The predetermined amount ofbiologically active compound 12 is then advanced from the syringethrough the hypodermic needle and into interior void 28 (see FIG. 4) ofchemical container 26 in a well known manner. Once an appropriate amountof biologically active compound 12 has been disposed within interiorvoid 28 the hypodermic needle of the syringe is withdrawn from diaphragm44 of loading aperture 122. It should be understood that diaphragm 44will self seal once the hypodermic needle is removed therefrom toprevent any biologically active compound 12 from leaking out throughloading aperture 122. It should also be understood that having aposterior wall 128 (see FIG. 5) of chemical container 26 made from atransparent or translucent substance (e.g. plastic) is contemplated sothat the surgeon can visually confirm that the chemical container 26 isloaded with biologically active compound 12.

Once both chemical containers 26 are loaded in the above describedmanner, each door 94 (see FIG. 3) is located in the open position andeach chemical container 26 is positioned within housing 34 of cannula16. Specifically, as shown in FIG. 1, each chemical container 26 ispositioned relative to housing 34 such that exit apertures 42 andpressure aperture 120 face passageways 88. Each chemical container 26 isfurther positioned relative to housing 34 such that ribs 126 (see FIG.5) formed on chemical container 26 are aligned with correspondinggrooves 130 (see FIG. 3) defined in exterior wall segment 110. Bothchemical containers 26 are then advanced toward passageways 88 such thatribs 126 are positioned within grooves 130 and both chemical containers26 are partially located within interior cavity 36 of housing 34.

It should be understood that positioning ribs 126 within grooves 130 inthe above described manner aligns each fluid delivery needle 38 in fluidcommunication with fluid delivery channel 22 (see FIG. 3) with acorresponding diaphragm 44 positioned within an exit aperture 42 (seeFIG. 4). In addition, positioning ribs 126 within grooves 130 alignseach fluid delivery needle 38 in fluid communication with pressure line46 (see FIG. 3) with a corresponding diaphragm 44 positioned within apressure aperture 120 (see FIG. 4). Once aligned in the above describedmanner, both chemical containers 26 are advanced further into interiorcavity 36 until each fluid delivery needle 38 in fluid communicationwith a fluid delivery channel 22 pierces and is advanced through thecorresponding diaphragm 44 positioned within an exit aperture 42 (seeFIG. 2). In a similar manner, both fluid delivery needles 38 in fluidcommunication with pressure line 46 pierce and are advanced through thecorresponding diaphragm 44 positioned within pressure aperture 120 (seeFIG. 2). Advancing fluid delivery needles 38 through diaphragms 44 inthe above described manner places each fluid delivery channel 22 influid communication with interior void 28 of the corresponding chemicalcontainer 26. In addition, pressure line 46 is placed in fluidcommunication with interior void 28 of each chemical container 26.

However, it should be appreciated that, in contrast to having chemicalcontainers 26 removable from housing 34 as described above, chemicalcontainers 26 can be integrally formed with housing 34 of cannula 16. Inthis situation, chemical containers 26 function in a substantiallyidentical manner as described above, with the exception that chemicalcontainers 26 are never removed from housing 34. In particular, chemicalcontainers 26 are loaded with a predetermined amount of biologicallyactive compound 12 while the chemical containers 26 are positionedwithin and secured to housing 34. Moreover, it should be understood thatchemical containers can be integrally formed with cannula 16 such thatchemical containers are never removed from cannula 16.

After placing fluid delivery channels 22 and pressure line 46 in fluidcommunication with interior void 28 of each chemical container 26 doors94 are located in the closed position. Insufflation valve 108 andpressure control valve 50 are then positioned such that pressure line 46(see FIG. 2) is in fluid communication with pressure source 48.Pressurized fluid (i.e. CO₂) is then advanced from pressure source 48into interior void 28 of each chemical container 26 via the fluiddelivery needles 38 extending through pressure apertures 120. Advancingfluid into interior void 28 increases the pressure therein. However, itshould be understood that pressure control valve 50 can be adjusted tocontrol the pressure within interior void 28 of each chemical container26. It should also be understood that pressure relief valve 124 isdesigned to release an amount of the pressurized fluid if the pressurewithin interior void 28 becomes to great. Since interior void 28 of eachchemical container 26 is in fluid communication with body cavity 56 viaa fluid path defined by exit ports 24, fluid delivery channels 22, andfluid delivery needles 38, having pressure relief valve 124 designed inthe above described manner also ensures that the pressure within bodycavity 56 does not become to great.

Once biologically active compound 12 is located in fluid deliverychannel 22, biologically active compound 12 is advanced along the lengthof cannula 16 in a direction indicated by arrow 132 as shown in FIG. 2.While being advanced in the above described manner, biologically activecompound 12 comes into fluid communication with exit ports 24 (see FIG.2). As biologically active compound 12 encounters each exit port 24 aportion of biologically compound 12 advances through each exit port 24and is delivered to outer surface 30 of cannula 16 as shown in FIG. 1.The above described process of delivering biologically active compound12 to outer surface 30 can be continued until both chemical containers26 are substantially emptied and essentially all of biologically activecompound 12 has been delivered to outer surface 30 of cannula 16.However, if required, the surgeon can reopen doors 94 and inject anadditional predetermined amount of biologically compound 12 into eachinterior void 28 of chemical containers 26 as described above so as tocontinue the process of delivering biologically active compound 12 toouter surface 30.

It should be appreciated that as biologically active compound 12 isdelivered to outer surface 30 of cannula 16 an amount of biologicallyactive compound 12 is transferred from outer surface 30 to side wall 58of opening 52 as shown in FIG. 1. In addition it should be appreciatedthat as biologically active compound 12 is delivered to outer surface 30of cannula 16 an amount of biologically active compound 12 can betransferred from outer surface 30 to an inside surface 57 of body cavity56 (see FIG. 1) by positioning cannula 16 at an angle relative to sidewall 58. It should further be appreciated that biologically activecompound 12 can be continuously transferred to side wall 58 and insidesurface 57 such that essentially the entire amount of biologicallyactive compound 12 contained in chemical containers 26 is transferred toside wall 58 and inside surface 57. Once located in contact with sidewall 58 or inside surface 57, biologically active compound 12establishes a “pharmacological barrier” that helps prevent tumor cellimplantation in opening 52 and/or the contamination of opening 52 withviable infectious microbes. Therefore, once opening 52 is protected inthe above described manner the surgical procedure can proceed.

If necessary, in order to keep biologically active compound 12 fromfalling or sliding off outer surface 30 due to gravity, or beingadvanced out of exit ports 24 to quickly, biologically active compound12 can contain a suitable pharmaceutically acceptable carrier. Suchpharmaceutically acceptable carriers include known excipients andauxiliaries which facilitate the processing of biologically activecompound 12 into a preparation which has the appropriate consistency tobe advanced out of exit ports 24 in a controlled manner and thusdisposed on outer surface 30, side wall 58, and interior surface 57.

Suitable excipients which may be used to prepare a pharmaceuticallyacceptable carrier, such as a paste or a viscous solution, includefillers such as saccharides, for example lactose or sucrose, mannitol orsorbitol, cellulose preparations and/or calcium phosphates, for exampletricalcium phosphate or calcium hydrogen phosphate, as well as binderssuch as starch paste, using, for example, maize starch, wheat starch,rice starch, potato starch, gelatin tragacanth, methyl cellulose,hydroxypropylmethylcellulose, sodium carboxymethylcellulose, and/orpolyvinyl pyrrolidone. If desired, disintegrating agents may be addedsuch as the above-mentioned starches and also carboxymethyl-starch,cross-linked polyvinyl pyrrolidone, agar, or alginic acid or a saltthereof, such as sodium alginate. Additionally, silica, talc, stearicacid or salts thereof such as magnesium stearate or calcium stearate,and/or polyethylene glycol can be used.

In addition, a suspension of biologically active compound 12 may bedisposed on outer surface 30 or side wall 58. Suitable vehicles for suchsuspensions include sesame oil or synthetic fatty acid esters, forexample, ethyl oleate or triglycerides. Such suspensions can includesubstances which increase the viscosity of the suspension including, forexample, sodium carboxymethyl cellulose, sorbitol and/or a dextran.

The exact formulation of a pharmaceutically acceptable carrier willdepend upon the particular nature of biologically active compound 12 tobe disposed upon outer surface 30 and is easily determinable by one ofordinary skill in the art from only routine experimentation.

Being able to deliver essentially all of biologically active compound 12contained within chemical containers 26 to side wall 58 or into bodycavity 56 allows a surgeon to accurately determine the total amount ofbiologically active compound 12 administered to a patient during asurgical procedure. Knowing the total amount of biologically activecompound 12 administered to the patient allows the surgeon to accuratelycontrol the dose administered to the patient and thus ensure that aproper dosage regimen for that particular patient is followed. Theproper dosage regimen for a particular patient is dependent upon severalfactors including the age, sex, weight, condition of the recipient, kindof concurrent treatment, if any, frequency of treatment and the natureof the effect desired. In addition, the dosage regimen will also dependupon the immunologic status of the patient and the aggressiveness of thetumor. Moreover, the amount of biologically active compound 12administered to the patient should be large enough to produce thedesired effect but not so large as to cause adverse side effects, suchas unwanted cross reactions, impaired wound healing, bleeding, impairedplatelet function, anaphylactic reactions and the like.Counterindication, if any, immune tolerance and other variables willalso affect the proper amount administered to the patient. The exactformulation of a pharmaceutically acceptable carrier and the amount ofbiologically active compound 12 contained therein (and therefore theamount administered to the patient) is easily determinable by one ofordinary skill in the art from only routine experimentation and byapplying well know principles of therapeutics as set forth, for example,in Gilman, Alfred G. et al., eds., The Pharmacological Basis ofTherapeutics, 6^(th) Edition, Macmillan Publishing Co., Inc. New York,N.Y. (1980) which is herein incorporated by reference. Preferably, suchpreparations will contain about 0.001 to about 99 percent biologicallyactive compound 12 together with the pharmaceutically acceptablecarrier.

The above described ability of the present invention which allows asurgeon to accurately determine the total amount of biologically activecompound 12 disposed on outer surface 30 (and thus administered to apatient) during a surgical procedure represents a significant advantageover other methods of disposing biologically active compound 12 onto amedical apparatus (e.g. dipping the medical apparatus in a solution orsuspension of biologically active compound 12 or the unquantifiedirrigation of opening 52 with biologically active compound 12).Specifically, many of the less accurate methods do not allow the surgeonto accurately control the amount of biologically active compound 12administered to the patient. Therefore, these less accurate methods ofdisposing biologically active compound 12 onto the medical apparatusmake it very difficult for the surgeon to ensure that a proper dosageregimen for a particular patient or cancer is being followed.

The present invention also allows a surgeon to avoid utilizing abiologically active compound 12 until it is deemed necessary. This isnot possible with the aforementioned less accurate methods. For example,the dipping of a medical apparatus (i.e. a medical apparatus similar tomedical apparatus 10) in a solution or suspension of biologically activecompound 12 must be performed prior to the beginning of the surgery at atime when the surgeon has not visually confirmed the presence of canceror infection in body cavity 56. The surgeon must dispose biologicallyactive compound 12 on the medical device before the beginning of thesurgery since withdrawing the medical apparatus after the surgery hasstarted would cause a loss of the insufflation of body cavity 56 whichcan complicate the surgical procedure. Therefore, in many circumstancesthe surgeon will unnecessarily utilize biologically active compound 12when no cancer or an infection is present which increases the cost ofthe surgical procedure. This is in contrast to the present inventionwhich allows the surgeon to (1) begin the surgical procedure, (2)confirm whether biologically active compound 12 is required, and (3)only if needed, administer an accurate controllable amount of biologicalcompound 12 to the patient without interrupting the surgical procedureand withdrawing medical apparatus 10 from body cavity 56.

Second Embodiment of the Invention

Now referring to FIG. 7, there is shown a medical apparatus 60 similarto the medical apparatus 10 shown in FIG. 1. Medical apparatus 60 isshown advanced through an opening 134 in a wall 136 of a body cavity138. Medical apparatus 60 includes a trocar assembly 78, a sleeve 62,and a pair of chemical containers 74. Trocar assembly 78 includes atrocar 82 positioned within a lumen 140 of a cannula 80. Trocar 82 ispositionable between a first trocar position and a second trocarposition as described above for trocar 18 (i.e. trocar 82 is positionedwith lumen 140 of cannula 80 in the first trocar position and completelyremoved from lumen 140 in the second trocar position).

Sleeve 62 is substantially identical in construction to cannula 16discussed above in reference to FIGS. 1, 2, 3, and 6 with the exceptionthat sleeve 62 includes a sealing member 86 extending therefrom. Forexample, sleeve 62 also includes (1) a wall 84 having an outer surface76, (2) a working channel 64 defined by wall 84, (3) a housing 70, and(4) a pair of fluid delivery channels 66 which are distinct from workingchannel 64 and are in fluid communication with a number of exit ports68. As shown in FIG. 7, fluid delivery channels 66 are preferablydefined in wall 84 of sleeve 62 and extend all the way to an end 142 ofsealing member 86. It should be understood that sealing member 86operates in a substantially identical manner, and has a substantiallyidentical construction and function, as sealing members described in aUnited States patent application filed on Oct. 21, 1997 havingapplication, Ser. No. 08/955,256 (inventor Stephen P. Moenning) which isincorporated herein by reference, with the exception that sealing member86 has fluid delivery channels 66 and exit ports 68 defined therein.

It should be understood that housing 70 is substantially identical inconstruction to housing 34 discussed above. Furthermore, fluid deliverychannels 66 are in fluid communication with the interior cavity (notshown) of housing 70 in a substantially identical manner as describedabove in reference to fluid delivery channels 22.

Moreover, each chemical container 74 is constructed in a substantiallyidentical manner as that described above for chemical containers 26. Forexample, each chemical container 74 has an interior void (not shown; seeFIG. 3) defined therein for receiving biologically active compound 12.

Medical apparatus 60 is used in a similar fashion as that describedabove for medical apparatus 10 with some modifications to account forthe presence of sleeve 62. Specifically, trocar 82 is initially locatedin the first trocar position, and trocar assembly 78 is positionedwithin working channel 64 of sleeve 62 as shown in phantom in FIG. 7.Sealing member 86 is then positioned in a substantially parallelrelationship with working channel 64 of sleeve 62. Trocar 82 of medicalapparatus 60 is then placed in contact with, and advanced through, wall136 of body cavity 138 to create opening 134. Once medical apparatus 60is positioned as described above, trocar 82 is moved to the secondtrocar position. Sealing member 86 is then positioned in a substantiallyorthogonal relationship with working channel 64 of sleeve 62 as shown inFIG. 7. Sleeve 62 is then positioned relative to opening 134 such thatsealing member 86 makes contact with an interior surface 144 of bodycavity 138.

Body cavity 138 is then insufflated in a similar manner as thatdescribed above in reference to FIG. 6 (i.e. body cavity 134 isinsufflated via the insufflation valve (not shown) attached to housing70 and pressure source 48. Once body cavity 138 is insufflated, and aspreviously discussed a determination is made that biologically activecompound 12 is required based upon the presence of a cancer or aninfection within body cavity 138, chemical containers 74 are loaded withbiologically active compound 12 as previously described. Once loaded,chemical containers 74 are positioned within the interior cavity (notshown) of housing 70 in a substantially identical manner as thatpreviously described above in reference to FIGS. 1-5. That is, chemicalcontainers 74 are positioned within the interior cavity of housing 74such that the interior void of each chemical container 74 is in fluidcommunication with (1) a fluid delivery channel 66 and (2) a pressureline defined in housing 70 which is substantially identical to pressureline 46 defined in housing 34 (see FIG. 2).

Once chemical containers 74 are positioned in the above describedmanner, the insufflation valve (not shown) and a pressure control valve(not shown) attached to housing 70 (i.e. a pressure control valvesubstantially identical to pressure control valve 50) are manipulatedsuch that the interior void of each chemical container 74 is in fluidcommunication with pressure source 48. Bringing the interior void ofeach chemical container 74 into fluid communication with pressure source48 advances biologically active compound 12 contained therein into eachfluid delivery channel 66.

Once biologically active compound 12 is located in fluid deliverychannel 66, biologically active compound 12 is advanced along the lengthof sleeve 62 and sealing member 86 in a direction indicated by arrows146 and 147 as shown in FIG. 7. While being advanced in the abovedescribed manner, biologically active compound 12 comes into fluidcommunication with exit ports 68. As biologically active compound 12encounters each exit port 68 a portion of biologically compound 12advances through each exit port 68 and is delivered to outer surface 76of sleeve 62 in a manner similar to that shown in FIG. 1. In addition,an amount of biologically active compound 12 is delivered to a contactsurface 150 of sealing member 86. It should be appreciated that asbiologically active compound 12 is delivered to outer surface 76 ofsleeve 62 an amount of biologically active compound 12 is transferredfrom outer surface 76 to side wall 148 of opening 134 as shown in FIG.7. In addition, it should be appreciated that as biologically activecompound 12 is delivered to contact surface 150 of sealing member 86 anamount of biologically active compound 12 is transferred from contactsurface 150 into contact with interior surface 144 of body cavity 138.It should further be appreciated that biologically active compound 12can be continuously transferred to side wall 148 and interior surface144 such that essentially the entire amount of biologically activecompound 12 contained in chemical containers 74 is transferred to sidewall 148 and interior surface 144. Once located in contact with sidewall 148 and interior surface 144, biologically active compound 12establishes a “pharmacological barrier” that helps prevent tumor cellimplantation in opening 134 and/or the contamination of opening 134 withviable infectious microbes. Therefore, it should be understood thatmedical apparatus 60 has all of the advantages as described above inreference to medical apparatus 10.

Third Embodiment of the Invention

Referring to FIGS. 9 and 10, there is shown a medical apparatus 200 ofthe present invention advanced through opening 52 (i.e. the port sitewound) in wall 54 of body cavity 56. Medical apparatus 200 issubstantially identical to medical apparatus 10, therefore thecomponents of medical apparatus 200 have the same reference numbers asmedical apparatus 10. In addition, it should be understood that medicalapparatus 200 functions in substantially the same way, and has the sameadvantages as, medical apparatus 10. Therefore, only the differencesbetween medical apparatus 10 and medical apparatus 200 will be discussedin detail herein.

With respect to the differences between medical apparatus 10 and medicalapparatus 200, rather than having delivery channels 22 defined incannula 16, medical apparatus 200 has grooves 202 defined in outersurface 30 of cannula 16. Similar to delivery channels 22, grooves 202function to deliver a biologically active compound to outer surface 30of cannula 16. As shown in FIG. 10, each groove 202 is in fluidcommunication with interior void 28 of a chemical container 26 via aconduit 204 defined in housing 34.

Medical apparatus 200 is used in a substantially identical fashion asthat described above for medical apparatus 10. Once medical apparatus200 is positioned as shown in FIG. 9, body cavity 56 is insufflated inan identical manner as that described above in reference to FIG. 6. Oncebody cavity 56 is insufflated, and as previously discussed adetermination is made that biologically active compound 12 is requiredbased upon the presence of a cancer or an infection within body cavity56, chemical containers 26 are loaded with biologically active compound12 as previously described. Once loaded, chemical containers 26 arepositioned within the interior cavity 36 of housing 34 in asubstantially identical manner as that previously described above inreference to FIGS. 1-5. That is, chemical containers 26 are positionedwithin the interior cavity 36 of housing 34 such that the interior voidof each chemical container 26 is in fluid communication with (1) aconduit 204 and (2) a groove 202.

Once chemical containers 26 are positioned in the above describedmanner, the insufflation valve 108 and pressure control valve 50 aremanipulated such that the interior void of each chemical container 26 isin fluid communication with pressure source 48. Bringing the interiorvoid of each chemical container 26 into fluid communication withpressure source 48 advances biologically active compound 12 containedtherein into each groove 202 via conduits 204.

Once biologically active compound 12 is located in grooves 202,biologically active compound 12 is advanced along the length of cannula16 in a direction indicated by arrow 206 as shown in FIG. 9. It shouldbe appreciated that as biologically active compound 12 is advancedthrough grooves 202 an amount of biologically active compound 12 istransferred from outer surface 30 to side wall 58 of opening 52 as shownin FIG. 9. In addition, it should be appreciated that as biologicallyactive compound 12 is advanced through grooves 202, an amount ofbiologically active compound 12 is transferred from outer surface 30 toside wall 58 of opening 52 as shown in FIG. 9. In addition, it should beappreciated that as biologically active compound 12 is advanced throughgrooves 202 and transferred to side wall 58 of opening 52, biologicallyactive compound 12 establishes a “pharmacological barrier” that preventstumor cell implantation in opening 52 and/or the contamination ofopening 52 with viable infectious microbes. Therefore, once opening 52is protected in the above described manner the surgical procedure canproceed.

If necessary, the distal portion of each groove 202 can have a spongematerial 214 disposed therein, as shown in FIG. 9. For example, thedistal two thirds of each groove 202 can have sponge material 214disposed therein. Having sponge material 214 disposed within each groove202 ensures that no insufflation gas is allowed to escape from withinbody cavity 56 through grooves 202. In particular, as biologicallyactive compound 12 advances down each groove 202 in the directionindicated by arrow 206 biologically active compound 12 comes intocontact with sponge material 214 disposed within groove 202. Contactingsponge material 214 with biologically active compound 12 results insponge material 214 swelling so as to fill groove 202 and thus preventany insufflation from escaping from body cavity 56 via groove 202.However, it should be understood that sponge material 214 still allowsbiologically active compound 12 to pass therethrough and be disposedupon side wall 58 of opening 52. It should be understood that spongematerial 214 can be any porous, liquid absorbent material, which allowsthe passage of biologically active compound 12 therethrough whilepreventing the leakage of insufflation gas, and can be temporarilyinserted into a body cavity such as body cavity 56. For, example spongematerial 214 can be made from a surgical sponge.

As shown in FIGS. 11 and 12, in contrast to having groves 202 defined inouter surface 30 of cannula 16, grooves 202 can also be defined in aninterior surface 208 of cannula 16. When grooves 202 are defined ininterior surface 208, medical apparatus 200 functions is a substantiallyidentical manner as described above in reference to FIGS. 9 and 10 withthe exception that each groove 202 is in fluid communication with anexit port 210 defined in cannula 16. Each exit port 210 leads frominterior surface 208 to outer surface 30. Therefore, as biologicallyactive compound 12 is advanced through each groove 202 in the directionindicated by arrow 206 (see FIG. 11) biologically active compound 12comes into contact with, and is advanced through, an exit port 210 suchthat biologically active compound 12 is transferred from interiorsurface 208 to outer surface 30 of cannula 16 in the direction indicatedby arrow 212 (see FIG. 12). (Note that while exit ports 210 are shownbeing defined in substantially the entire length cannula 16, it is alsocontemplated that exit ports 210 are only defined in, for example, thedistal two thirds of cannula 16.) Once biologically active compound 12is transferred to outer surface 30 of cannula 16, biologically activecompound 12 is transferred to side wall 58 of opening 52 where itestablishes a “pharmacological barrier” that prevents tumor cellimplantation in opening 52 and/or the contamination of opening 52 withviable infectious microbes.

While the invention has been illustrated and described in detail in thedrawings and foregoing description, such illustration and description isto be considered as exemplary and not restrictive in character, it beingunderstood that only the preferred embodiments have been shown anddescribed and that all changes and modifications that come within thespirit of the invention are desired to be protected. For example, whilechemical containers 26 and 74 are described above as being separate fromhousings 34 and 70, respectively, other arrangements are contemplated.As discussed above, one such arrangement incorporates chemicalcontainers 26 and 74 into housings 34 and 70, respectively, such thateach chemical container is “built in” or integral to the housing.

What is claimed is:
 1. A medical procedure for dispensing a biologicallyactive compound, comprising said steps of: creating an opening in a wallof a non-vascular body cavity; advancing a medical apparatus throughsaid opening and into said non-vascular body cavity, said medicalapparatus including a trocar assembly having (1) a cannula and a trocar,wherein (A) said cannula has a working channel defined therein throughwhich medical instruments may be advanced, (B) said cannula includes afluid delivery channel which is distinct from said working channel, and(C) said fluid delivery channel has an exit, and (2) a chemicalcontainer having an interior void defined therein for receiving saidbiologically active compound, said interior void being in fluidcommunication with said exit through said fluid delivery channel; andadvancing said biologically active compound from said interior void ofsaid chemical container onto an exterior surface of said cannula througha fluid path defined by said fluid delivery channel.
 2. The medicalprocedure of claim 1, wherein: said biologically active compoundadvancing step includes a step of positioning said medical apparatusrelative to said opening such that an amount of said biologically activecompound is transferred from said exterior surface of said cannula to aside wall of said opening.
 3. The medical procedure of claim 1, wherein:said fluid delivery channel includes a groove defined in a surface ofsaid cannula.
 4. The medical procedure of claim 1, wherein: said trocaris positionable between a first trocar position and a second trocarposition, said trocar is positioned within said working channel of saidcannula when said trocar is positioned at said first trocar position,and said trocar is completely removed from said working channel of saidcannula when said trocar is positioned at said second trocar position.5. The medical procedure of claim 1, wherein: said fluid deliverychannel is defined in a wall of said cannula.
 6. A medical procedure fordispensing a biologically active compound, comprising the steps of:creating an opening in a wall of a body cavity; advancing a medicalapparatus through the opening and into the body cavity, said medicalapparatus including a trocar assembly having (1) a cannula and a trocar,wherein (A) said cannula has a working channel defined therein throughwhich medical instruments may be advanced, (B) said cannula includes afluid delivery channel which is distinct from said working channel, and(C) said fluid delivery channel has an exit port, and (2) a chemicalcontainer having an interior void defined therein for receiving saidbiologically active compound, said interior void being in fluidcommunication with said exit port through said fluid delivery channel;advancing a gas into said body cavity; visualizing the body cavity; andadvancing said biologically active compound from said interior void ofsaid chemical container onto an exterior surface of said cannula througha fluid path defined by said fluid delivery channel.